1. Field of the Invention
The present invention relates generally to methods and apparatus for controlling the eating by a person and more particularly to methods and apparatus for controlling eating by a person based on behavioral control principles.
2. Description of the Prior Art
Numerous approaches, methods, devices, and drugs have been suggested and utilized in the past to control the weight of the human being. None of the above such prior art approaches, however, have been so effective in maintaining long term weight reduction as the prior art approach hereinafter referred to as "behavioral control".
"A Review of Behavioral Approaches to Weight Control" by Edward E. Abramson. Behavior Research and Therapy, Vol. II, pages 547 to 556, 1973. PA1 "The Control of Eating" by Ferster, C. B.; Nurnberger, J. I.; & Levitt, E. B. The Journal of Mathetics, Vol. 1, pages 87-109, 1962. PA1 "Behavior Control of Overeating" by Richard B. Stuart. Behavioral Research and Therapy, Vol. 5, pages 357-365, 1976. PA1 The Behavioral Control of Overeating by James M. Shulman, M. A. Thesis, Univ. of Montana, 1971. PA1 "Relationship Between Eating Rates and Obesity" by Gaul, D. J.; Craighead, W. E.; & Mahoney, M. J., J. of Consulting and Clinical Psychology, Vol. 43, No. 2, pages 123-125, 1975. PA1 "Eating Responses of Obese and Nonobese Humans during Dinner Meals" by Hill, S. W. & McCutcheon, N. B., Psychosomatic Medicine, Vol. 37, No. 5, Sept.-Oct., pages 395-401, 1975. PA1 "Permanence of Two Self-Managed Treatments of Overweight in University and Community Populations" by Hall, S. M.; Hall, R. G.; Hanson, R. W.; & Borden, B. L., J. of Consulting and Clinical Psychology, Vol. 42, No. 6, pages 781-786, 1974. PA1 "A Comparison of Two Forms of Self-Monitoring in a Behavioral Weight Reduction Program" by Bellack, A. S.; Rozensky, R.; & Schwartz, J. Behavior Therapy, Vol. 5, pages 523-530, 1974. PA1 "Self-Monitoring in the Treatment of Obesity: Parameters of Reactivity" by Raymond G. Romanczyk, Behavior Therapy, Vol. 5, pages 531-540, 1974. PA1 "Relationship Between Eating Rates and Obesity" by Gaul, D. J.; Craighead, W. E.; & Mahoney, M. J., J. of Consulting and Clinical Psychology, Vol. 43, No. 2, pages 123-125, 1975. PA1 "Why Not Give Your Clients a Counter: A Survey of What Happened When We Did", Zimmerman, J. and Levitt, E. E. Behavioral Research and Therapy, Vol. 13, pages 333-337, 1975. PA1 (1) Lengthening the chain of eating, PA1 (2) Satiation of hunger with less food by increasing meal length. PA1 (3) Decreasing the amount of food, and PA1 (4) Feedback or self-cueing.
In 1962, it was suggested that the application of reinforcement theory to the behavior of human eating would be an effective approach for losing weight and for maintaining the weight loss over a long period of time,
Ferster suggested that if an individual would gain control of the factors which determine "how often" and "how much" one eats, then weight loss could be accomplished. The importance of lengthening the chain of responses leading to swallowing of food in order to weaken the disposition to start the chain of eating is discussed to reduce the frequency with which eating is carried out. Various exercises are suggested to lengthen the chain, such as placing food on the fork only after other food is swallowed and the mouth is empty, interrupting the meal for increasing amounts of time, and prolonging chewing before swallowing for increasing periods.
Persons have generally been observed to eat rapidly whenever they eat, so that large quantities of food are consumed in brief periods. To slow the process of ingestion, it has been recommended to place a small amount of food in the mouth and to replace the utensils on the table until the food is swallowed.
By eating more slowly, and lengthening the chain of responses, the person generally improves digestion, eliminates indigestion, and eventually achieves a normal state of satiation with less food intake. Satiation is accomplished since it normally takes at least 15-20 minutes after beginning to eat before a person begins to feel the effects of food.
The two aforesaid references, therefore, recommend a set of exercises to break up the chain of eating and to lengthen the meal time by replacing the silverware on the table after placing food in the mouth and by chewing food slowly. Shulman further suggests that during the latter part of the meal when hunger is not as potent as earlier, a person should take a 2-5 minute break. A physiological factor in satiation may be increased mastication.
It has now been firmly established that one who eats rapidly might overeat and gain weight because he ingests a large "excess" of food between the time he is full and the time the satiety mechanism inhibits eating.
Obese people clearly eat slightly larger bites (grams per bite) and chew slightly faster or with less chewing per bite than non-obese people.
In addition to breaking up and lengthening the chain of eating leading to satiation, another behavioral control factor is observed to be found in decreasing the quantity of food taken in by reducing the number of mouthfuls per meal. Shulman recommended that each week for ten weeks the number of actual mouthfuls of food per meal should be recorded so that an average number of mouthfuls per meal could be determined. Shulman suggested that a goal of a predetermined number of less mouthfuls per meal would result in a slow and gradual weight loss. One prior art behavioral approach to weight reduction is termed "simple self-management".
The method and apparatus taught by the Hall "simple self-management" approach is to monitor the number of bites of food ingested per day and to record this daily on data sheets. The users were then given a Borm wrist response counter to record bites of food taken. The average number of bites per day were then decreased weekly by three. At the end of two weeks, if the user had lost 1-2 pounds per week for both weeks, he was instructed to keep the bites per day at the average level for the previous week. If a loss of this magnitude had not occurred, the user was instructed to decrease his bites per day by three until he was losing 1-2 pounds per week for two successive weeks. If at any time a subject lost more than two pounds per week for two successive weeks, he increased the number of bites per day by three until no more than two pounds per week were lost.
Other experimental results indicate that the additional factor of feedback may be important in weight control.
Specifically, each person was required to record prior to eating the amount, time, and place of eating. Persons doing this pre-behavior step lost more weight than those who reported such information after eating. Feedback which apparently does not effect self-monitoring of weight control is daily measuring of weight.
However, prompting or reminding oneself of the end result of losing weight such as monitoring caloric intake does have a significant effect. Id. This has been termed "self-cueing". It has been observed that, by increasing the "rate of self-cueing", significant results would be obtained.
Unfortunately, obese individuals are significantly less accurate in self-monitoring than non-obese individuals.
When asked to reduce the number of bites, obese individuals generally reduce the bites but increase the amount and the speed of the bites.
The importance of using a counting device in conducting experiments on behavioral change has been recognized in clinical analysis as an effective research tool and the reactive effects of such recording leads to behavioral changes primarily because of the counting and recording activity.
Unfortunately, prior art attempts to count the number of chews per bit has turned out to be a rather tedious and difficult task as a cueing strategy. Id. at 125. Furthermore, while many prior art solutions have been suggested for slowing the pace of eating, all of them have a critical common element--namely, each must make you more aware of your eating. It has been suggested to eat with unusual utensils such as chop sticks or to eat with a non-dominate hand, to swallow your bite before putting the next item on your fork, and to actually put the utensils or sandwich down between bites. These are often dramatic changes in the eating habits and reminders have been employed to aid in reconditioning the person. A bandage placed on the finger or some special cue on the hand has been used. Even signs such as "SLOW DOWN" have been placed next to the plate.
None of the above prior art approaches have considered or suggested a unified method and apparatus for weight reduction, maintenance, or gain based on behavioral control principles such as:
The method and apparatus of the present invention provides, for the first time, such a unified approach designed for the consuming public.
Specifically, the method and apparatus of the present invention provides a highly visible physical "aid" in the form of a counter/pacer and display. At each meal, the physical appearance of the apparatus of the present invention provides feedback to the mind of the user that he is to be concentrating on losing, maintaining, or gaining weight. The physical presence of this counter and display on the table visibly stands apart from other common table items.
Specifically, the present invention requires the user to first determine his average number of bites per meal using the apparatus of the present invention. Once the average number of bites per meal has been determined, the user records the desired weekly goal on the counter and display of the present invention. The average weekly goal to lose weight is generally one bite less per meal than that initially determined. The weight loss over a week-by-week period should be according to that taught by the Hall "Simple Self-Management Approach". (That is, 1-2 pounds per week should be the average weekly loss.) If greater than 1-2 pounds per week is observed, then the average number of bites per meal is increased, if no weight loss is recorded on a weekly basis, then an additional bite is subtracted from the daily average. The act of visibly displaying the average daily bites at the start of the week and constantly having the average daily bites per meal displayed while eating provides a "self-cueing" of weight control. Weight maintenance and weight gain is accomplished by maintaining or increasing the bites per meal, respectively.
While eating each meal, the user of the present invention presses a button before each bite, the pressing of the button increments a counter which causes a visible display to be activated displaying the number of the bite being taken. When the button is released, a light flashes to provide a cadence from which the user is conditioned to chew at the cadence rate. A steady indication of the light is made, informing the user that his bite was too large if the user had not finished his bite in a predetermined time interval. If the user has not taken a large enough bite, then he is finished chewing and swallowing prior to the steady light indication. If this happens, the user must take a larger bite the next bite. Furthermore, the user must wait until the light becomes steady and then push the button prior to taking the next bite. Pressing the button before the light becomes steady will not advance the counter. This sequence of events lengthens and interrupts the eating chain, enables greater satiation to occur for the amount of food consumed, provides, for the first time, a convenient means for keeping uniform the amount of food in each bite, and provides continuous self-cueing feedback to the user. None of the above prior art approaches suggest or disclose such an approach. Indeed, none of the above approaches suggests or discloses a means for pacing the chewing rate of each bite or controlling the size of food in each bite.